NPIMap

Organization Active NPI

Florida Specialty Medical Services LLC

  • Dermatology Physician
  • Tampa, FL
National Provider Identifier
1285051409
Registry record updated Mar 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME100378 Issued in FL
Legal business name
FLORIDA SPECIALTY MEDICAL SERVICES LLC
Practice address
16057 Tampa Palms Blvd W
223
Tampa, FL 33647-2001
Phone
(813) 493-3376
NPI assigned
Mar 26, 2014
Organization subpart
Yes
Parent organization
AMERICAN SPECIALTY MEDICAL SERVICES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 26, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Debra Shelby, DNP
Title
Owner/Manager
Phone
(772) 708-6776

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X ME100378 FL Primary

Addresses

Primary practice location

16057 Tampa Palms Blvd W
223
Tampa, FL 33647-2001

Mailing address

16057 Tampa Palms Blvd W
223
Tampa, FL 33647-2001
Phone (813) 493-3376

National Provider Directory

National Provider Directory

Locations

4 Maggie Ln
Sarasota, FL 34232
Phone (813) 765-0688

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395792000000",
    "number": "1285051409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16057 TAMPA PALMS BLVD W",
            "address_2": "223",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472001",
            "telephone_number": "813-493-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16057 TAMPA PALMS BLVD W",
            "address_2": "223",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472001",
            "telephone_number": "813-493-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA SPECIALTY MEDICAL SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMERICAN SPECIALTY MEDICAL SERVICES LLC",
        "enumeration_date": "2014-03-26",
        "last_updated": "2014-03-26",
        "status": "A",
        "authorized_official_last_name": "SHELBY",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "772-708-6776",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME100378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.